Ernest Amory Codman was the courageous early 20th century champion for an “end results system” to track hospital outcomes, an idea his surgical colleagues did not welcome. If he were to come back to life today, he would feel vindicated, perhaps smiling to discover the American College of Surgeons’ National Surgical Quality Improvement Program (ACS NSQIP), launched in 2001, 83 years after he self-published A Study in Hospital Efficiency.1